Iranian Journal of Diabetes and Obesity
Volume:1 Issue: 1, Autumn 2009

Diabetes mellitus and thyroid disease are the two common endocrinopathies seen in adult population. Studies to evaluate thyroid disorders in patients with type 2 diabetes are lacking. The aim of this study was to compare prevalence of thyroid dysfunction and autoimmunity in type 2 diabetic patients with age and sex matched non-diabetic control group.
Among patients referred to Yazd Diabetes Research Center, 2797 type 2 diabetic patients were recruited. Clinical examination were carried out and samples for thyroid function test were obtained including thyroxin (T4), triiodothyronine (T3), Thyroid Stimulating Hormone (TSH), T3 Resin Uptake (T3RU), thyroid peroxidase antibodies (TPO-Ab) and thyroglobulin antibodies (TG-Ab). They were compared with 4844 non-diabetic, age and sex matched control subjects.
Our findings showed that the levels of thyroid hormone were not significantly different from levels in non-diabetic controls (P < 0.05). Positive TPO antibody was found in 1032 type 2 diabetic patients (36.9%) versus 1802 (37.2%) in control group (P = 0.8). Positive both thyroid antibodies, TPO antibody and TG antibody were found in 314 diabetic patients; (11.2%) versus 516 (10.8%) in controls (P = 0.54).
Our findings indicate that the frequency of thyroid autoimmunity is not significantly higher in type 2 diabetic patients than in non-diabetic control group.

Hyperglycemia is associated with increased morbidity and mortality in diabetic patients following coronary artery bypass grafting. Tight glycemic control in perioperative period can reduce these events. The goal of this study was to determine whether combination of continuous infusion and subcutaneous glargine as a basal insulin could improve glycemic control.
Diabetic patients who were candidate for CABG were randomized to receive continuous insulin infusion with or without subcutaneous Glargine insulin for at least 72 hours which started 24 hours before surgery and continued for 48 hours after surgery.
A total 84 subjects were required. In group A (n = 45) continuous insulin infusion was used for glycemic control and in group B (n = 39) we used continuous insulin infusion with sub cutaneous glargine insulin. Blood glucose level was significantly better in desirable range in group B in comparison to group A. Total mean blood glucose level in group A was 186.1 mg/dl and in group B was 174.3 mg/dl (P = 0.008). Frequency of hypoglycemia (blood glucose <70 mg/dl) was 0.66% in group A and 0.5% in group B that was similar (P = 0.530). The mean length of stay in the hospital was not different between two groups (P = 0.288).
We found out that a combination of continuous insulin infusion and glargine insulin as main basal insulin can improve glycemic control in diabetic patients undergoing coronary artery bypass grafting.

Type 2 diabetes is associated with elevated oxidative stress and decline in antioxidant defense. Vitamin E supplementation reduces oxidative stress level in diabetic patients. Purpose of this study was to evaluate the effect of vitamin E supplementation on glycemic control and lipid profile in type 2 diabetic patients.
In this study 31 type 2 diabetic patients with Fasting blood Sugar (FBS):140-200 mg/dl, Triglyceride (TG): 200-400 mg/dl, Cholesterol (TC): 200-300 mg/dl and mild hypertension were selected. Subjects received vitamin E 800 IU/day for 3 months. At the baseline and end of the study FBS, TC, TG, LDL, HDL, Glycated hemoglobin and fasting insulin level were measured.
In this study 31 type 2 diabetic patients (19 female, 12 male) with mean age 53.03 ± 8.87 years were studied. Vitamin E supplementation for 3 months had no positive effect on type 2 diabetic patients. As FBS, TG and fasting insulin decreased but this decline was not significant. Also total Cholesterol, systolic and diastolic blood pressure changes were not remarkable.
Results of this study showed that 800 IU vitamin E administration for 3 months could not improve blood glucose, lipids , HbA1c, fasting insulin, systolic and diastolic BP in type 2 diabetic patients.

Leptin is a hormone resulting from the obesity gene which could be important in the pathogenesis of the insulin. Only limited data concerning the interaction of insulin, glucose tolerance and free leptin are available and no data exist on the potential influence of free vs. bound circulating leptin. We, therefore, studied percentage of free to total leptin in diabetic patients.
30 kg/m²) and 30 non-insulin dependent diabetic non-obese patients (age: 50±20 years, BMI <25 kg/m²) were studied. Free leptin was purified by Gel filtration chromatography and the fractions were collected and then their free leptin was measured by a high sensitive ELISA method. Circulation total leptin and insulin was measured by ELISA.
Circulation total leptin was significantly correlated to insulin (P < 0.005). Percentage of free leptin to total in obese subjects was more than non-obese subjects (27% ± %1 vs. %3 ± %4, [P < 0.001]). Percentage of free to total leptin showed a positive correlation with insulin (r = 0.58 [P < 0.001]), insulin resistance (r = 31 [P < 0.015]) and BMI (r = 0.86 [P < 0.001]).
The majority of leptin which circulates in obese individuals was free form. Presumably it is bioactive protein of hormone and thus obese subjects are resistant to free leptin.

Type 2 diabetes mellitus is a chronic illness causing considerable morbidity and mortality. Enormous advances have been made in medical care but more people are still having tendency to use herbal or alternative remedies. This study is a randomized, controlled trial on type 2 diabetic patients. The subject consisted of 60 patients divided randomly into three groups and supplemented daily with 100 mg sodium metavanadate and 660 mg zinc sulfate or placebo for six weeks. The following were checked at baseline of the study and after six weeks: Body Mass Index (BMI), Blood Pressure (BP), Fasting Blood Sugar (FBS), 2-h postprandial glucose (2hpp), Glycated hemoglobin (HbA1c), Triglyceride (TG), Total Cholesterol (TC), Low-Density Lipoproteins, and High-Density Lipoproteins. Also HbA1c, BMI and BP were measured after 12 weeks to evaluate the long-term effects of drugs. Statistical analysis was performed using SPSS 11.5. Data of continuous variables are expressed as means ± standard deviation. Differences between groups were assessed by the paired T-test. Comparison between three groups was done by Post Hoc Tests. Mean age of patients was 51.39 ± 8.60 years. The results of this study show a significant decrease in TG (P = 0.01) and BMI (P = 0.03). After 12 weeks, there was a significant decrease in BMI (P =0.01) in Sodium metavanadate group. Due to zinc sulfate administration, significant decrease was seen in TG (P =0.005), TC (P = 0.02), LDL (P = 0.01) and systolic blood pressure (P = 0.02). After 12 weeks, there was a significant decrease in HbA1c (P = 0.04) with zinc sulfate consumption. Consumption of zinc sulfate in type 2 diabetic patients could be effective in lipid profile. It is recommended to use another vanadium compound to achieve better results.

The aim of this study was to determine the prevalence and risk factors of the sensory neuropathy in type 2 diabetic patients referring to Yazd Diabetes Research Center. Neuropathy is one of the most common complications of both type 1 and type 2 diabetes mellitus.
This is a cross-sectional study on 2350 diabetic patients (1071 male, 1279 female) referred to Yazd Diabetes Research Center (Iran) from June 2007 to February 2008. Data collection was carried out through a questionnaire including demographic subject, duration, body weight and length, lab test (HbA1c, 2hpp, FBS), Body Mass Index (BMI). Blood Pressure was measured on the right arm after a five-min rest. Neuropathy was confirmed using a Semmes Weinstein 10 g monofilament over 10 areas of the feet, ankle reflexes and vibration over the great toe and ankle.
The prevalence of type 2 diabetes and diabetic sensory neuropathy in Yazd province is 14.5% and 51.7%, respectively. The prevalence of sensory neuropathy in male was 49.9% and 53.2 % in female, that increased by age (P = 0.001), duration of diabetes (P = 0.001), HbA1c (P = 0.001) and poor glycemic control (high FBS and 2hpp).
Age, duration of diabetes, HbA1c and poor glycemic control were considered to be the risk factors for sensory neuropathy

Type 2 diabetes is a common disorder recognized as a major health problem in Iran. Diabetes is a major source of morbidity, mortality and economic cost to society. Diabetic patients are at risk of experiencing macrovascular and microvascular complications of diabetes. The aim of this study was to assess the prevalence of type 2 diabetes complications and their contributing factors.
This cross-sectional study was carried out on 1000 the type 2 diabetic patients referred to Yazd Diabetes Research Center. All diabetic patients underwent the specific tests for retinopathy, nephropathy, neuropathy, peripheral vascular diseases (PVD) and cardiovascular diseases (CAD). Logistic regression analysis was used to find out strength of association of risk factors with a specific complication.
In this study 1000 type 2 diabetic patients (457 male, 543 female) were studied. Nephropathy was diagnosed in 285 (28.5%), retinopathy in 519 (51.9%), CAD in 251 (25.1%), PVD in 143 (14.3%), CVA in 109 (10.9%) and foot ulcer in 84 patients (8.4%).
In this study the most important contributing factors in diabetic complications were age, duration of diabetes, systolic and diastolic blood pressure, glycated hemoglobin and Body Mass Index (BMI). So glycemic and blood pressure control can prevent diabetic complications or at least delay them.

This study was performed to compare the effectiveness of two methods of follow-up: Short Message Service (SMS) versus telephone call on glycosylated hemoglobin (HbA1c) in type 2 diabetes.
This semi-experimental study consisted of 77 patients with type 2 diabetes who were randomly assigned into two groups: telephone follow-up (n = 39) and Short Message Service (n = 38). Telephone interventions were applied by researchers for 3 months. SMS group received message daily for 12 weeks. Data were collected using data sheet to record HbA1c and a questionnaire consisted of demographic characteristics. Data gathering was performed at two points: at the baseline of the study and after 12 weeks. Data were analyzed by SPSS 11.5 using descriptive and inferential statistics methods.
Demographic variables were confirmed to be homogenous. The results of this study showed that both interventions had significant mean changes in HbA1c; for the telephone group (P = 0.001) with a mean change of -0.93% and for the SMS group (P = 0.001) with a mean change of -1.01%.
The findings of this research showed that intervention using SMS via mobile phone and nurse-led-telephone follow-up improves HbA1c for three months in type 2 diabetic patients and it can be considered as an alternative method for diabetes control.